Loading...
HomeMy WebLinkAboutBLD4081 SFR - BLD Permit / Conditions - 1/30/1979 Tompkins, William p. #4081 Tesh, Richard M. 1-30-79 Parcel D SW 1/4 SE 1.14 NW- 1/4 21-23-1 Take Old Belfair-Bremerton Hiway, turn at Newkirk Road, follow until road ends , site is on left side. Residence Plumbing Permit issued $33,634.00 IZSZ� z ���1�3n s/2 ?/Sy ` BUILDING PERMIT APPLICATION _ MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 Q DATE ISSUED PERMIT NO. ��� OWNER NAME IC q,407> Af. 'T MAIL ADDRESS CITY&STATE ZIP PHONE a^/ D!I E 951 oZ ?' ?fa w vTs DIRECTIONS iR� �,a 6.�LFAA2- D,ei7*V HI WWV, v/2,(/ AT .vswA!'OX l; �D, .T-'a Gto .J0 - 2a TO JOB SITE EiJDs _ -51rF- /S OA/ LIFT siAE' LEGAL /412061- ,a Dip- I(OCT IV 87GS (❑ SEE ATTACHED SHEET) DESCR. �� V4. OF S� f/4 D r, E W ©F SCG zI 25 N / S NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE CONTRACTOR USE OF BUILDING ,g) rgTE •��s�Dr.✓CE - $/it/6L� A7'(,N4iL Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: ©u c 4.c'1-145-G5 M141AI _�vo,2 -t74y41rsf1 T BAs�iN�-,�/� Valuation of work: $ 3 3 6 y o o PLAN CHECK FEE o PERMIT FEE /&Q 7 SPECIAL CONDITIONS: BEDROOMS DECKS CARPORT 9 NOTICE BATHROOMS_ TOTAL SO. FT.200-- GARAGE ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIESBASEMENT ATTACHED V OR AIR CONDITIONING. TOTAL SO. FT. FIREPLACE El DETACHED DETACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED gs(r CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER I Certify that I am a Currently registered contractor In WORK IS COMMENCED. the State of Washington and I the aware of the FOR OFFICE USE ONLY ordinance requirements regulating the work for which the permit is issued and all work done will be in conformance therewith. PERMANENTX, SHORELINES SEASONAL [I FLOODPLAIN I_ Firm E.D. NO. S.E.P.A. I i By Special Approvals IN OUT YES APPROVED NO Lic. No. Date ZONING PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT. PUBLIC WORKS I certify that I am exempt from the requirements of the FIRE MARSHAL contract or registration law RCW 18.27, and am aware of the Mason County ordinance requirements for BUILDING DEPT. which this permit is issued and that all work done will ROAD ACCESS be in conformance therewith. MOTOR VEHICLE PERMIT APPLICATION ACCEPTED BY PLA48 CHECK BY AP OVED F I SUANCE Owner ✓n ate . b C Jj PLV CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K. M.O. CASH le MASON COUNTY PLANNING DEPARTMENT P.O. BOX 186 Shelton,Washington 98584 PLUMBING PERMIT APPLICATION IMPORTANT— Complete ALL items. Mark boxes where applicable. Name Mailing address—Number,street,-city,and State Zip code s�Tel.No. 1. V111-1i/A •►� 41 L Fi Z Owner 9p/az c 2b !N. 3 AI ,5 LFj G 2. Contractor The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington Signature of applicant Address Application date e I. LEGAL DESCRIPTION T _ Location Building Xy o t .SF hlornc- 11w /f Sre- 2-1 2 3 n0 II.-I,--Sr NO. PLUMBING FIXTURES FEE WATER CLOSETS BASINS G.� BATHTUBS Z, SHOWERS QSt Mfg1pj SoftA'T OF- Lam_ / WATER HEATERS AUTO.WASHERS SINKS FLOOR DRAINS c DRINKING FOUNTAINS LAUNDRY TRAYS / � O Connect to City Sewer DISH WASHER z o Nv / DISPOSAL 1 / 7- ��.!ram URINAL f (Show Street Names & Property Lines) J ` V INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER. PERMIT SKETCH IN SEPTIC TANK & DRAIN FIELD LOCATION OR SUBMIT ON OTHER SKETCH. DO NOT WRITE IN THIS SPACE — FOR OFFICE USE Approved y Permit fee Date pemit Issued Permit number Receipt No. r L ^ PLOT PLAN ADDRESS / PERMIT NO. J�V o d LEGAL � pr' /✓IN /� Df 5E G 2 DESCRIPTION �/Q ' ffF4W 5#e,,e-T .01-A-gr #974625— ADDITION A N SITE AREA f �" AG AREA OF SITE OCCUPIED BY BUILDINGS 4fka —Sq. Ft. INSTRUCTIONS TO APPLICANT THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"=20' ARE y FILED WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAVE A SEPARATE PLOT PLAN.) fps FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN THE SPACE BELOW: LOCATION OF PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING SITE,AND SETBACK DIMEN- SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA- TION A"'D SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR- TION THEREOF. INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' a 2 4DG2 U N.1C •V G1 L4 h I/We certify that the proposed construction will conform to t nslo a bove and that no changes will be made Without first obtaining approval. I a k ��L� W i l h I M P o I&VA6 WAFA�(S) OF OWNER(S) OF SITE & STRUCTURE(S) (PRINT) SIGNATURE OF OWNERS OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED g DAB 3� z!F 6HEL��N I�rt'N'I�,� f